Immunological pathogenesis of endolymphatic hydrops and its relation to Menière's disease.

This study was designed to investigate an immunologically induced endolymphatic hydrops (ELH) and to focus on the issue of its pathogenesis in relation to Menière's disease. The time course of ELH was evaluated by light microscopy in a 2-hour to 7-month period following direct antigen challenge to the endolymphatic sac (ELS) in systemically pre-sensitized guinea pigs. ELH began to appear in the vestibule and the basal turn 5-7 hours after inner ear challenge and developed gradually. During the interval from the second day to the first week, ELH rapidly developed in all the cochlear turns and reached a maximum size. During the period from the second week to the eighth week, ELH gradually reduced. After 9 weeks, ELH of the saccule and the cochlea gradually recurred. During the interval from the first week to the eighth week, the time course of ELH correlated well with the grade of cellular infiltration of the perisaccular tissue. These results suggest that recurrent immunological reaction in the ELS may result in disorders of the ELS which finally lead to the onset of Menière's disease.